1. #1
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    Default Use of Ambulance/ Medic Crews at fires

    I am conducting a little informal reasearch on this subject. I want to know how departments that operate ambulances / medic units (staffed with cross-trained FF / EMT's and Medics) integrate these units into their fireground SOP's.

    In my dept, like so many in this part of the country, we are understaffed. We have 3 man engines and 2 on the trucks. To compensate, the medic crew combines with the truck crew at a fire to form a 4 man truck company.

    This works great, unless the medic unit is on a call....and this happens 4000+ times a year.

    The second part of my question is; how many other departments combine smaller units to form one "properly" staffed company, and how so?

    Thanks

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    Our medics may catch the hydrant or gofer tools, thats about it. No firefighting, no pumping, etc.

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    I can certainly sympathize with your situation.

    We have 4 houses. 3 of them are staffed with 2 man engine's (1 is a quint), supplemented with 2 man ALS fire/medic ambulances. The 4th house is staffd w/a 2 man engine with no medic unit.

    The way it is 'supposed' to work is they are to act as a company, but like you mentioned our medics are frequently out on EMS calls. Engine 3 (the house w/no medic unit) is basicaly on thier own until additional companies arrive, or they hook up w/another crew. This is obviously a very dangerous way to operate. In fact, 3 FFs were almost killed last year when they were caught in 'flashover like' conditions.

    We are now battling rumors that the city is considring contracting out the ambulance and reduce staffing even further. I don't know what we are going to do if this happens.

    Our Local is currently working with the chief's office to update our SOP's/SOG's on emergency operations. Right now there is no method to the maddness and that had a major contribution to the near tragedy we had last year.

    fieldseng2

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    We do not run an ambulance but the parish (county to the rest of the world) EMS service houses a unit with 2 paramedics at our station. We have an agreement with them that in the event of a structure fire they will have one of thier medics drive and pump our engine. Though they have no fire training provided by the EMS service, several of them either are currently career or volunteer firefighters either here or with other agencies, or have a firefighting background. In general the situation works fairly well and provides us an extra body or two, depending on who is riding the medic unit at the time.

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    we run a crew of 2 personnel on duty from 8-4 8 hours a day 7 days a week in the medic unit. They can pack up only if needed,, and normally they take command, spot a hydrant, check on occupancy, etc.
    IACOJ both divisions and PROUD OF IT !
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    Most of our crews are cross trained; all of the EMT's are firefighters; and we are in the process of setting up classes to make all the non-EMT fire personnel, First Responders.

    I guess it would depend on what the fire is, if the EMT's are fighting the fire or on the sidelines. All structure fires in severe heat and cold; we have rehab EMT's. All interior operations, have EMT's set aside for Rehab. Brush fires, more than what we can handle with a single alarm; EMT's don't assist w/ fire operations at all. Unless we have our rehab system wide spread. In that case, with each fire line crew, it's like a Military squad. For every 12 groundpounders, you get an EMT w/ a large medical/oxygen/trauma kit and some type of portable stretcher or back board to carry them out on the Gator.

    Surround & Drown fires, we may utilize EMS personnel on nozzles, water supply, pumps; but never too far from the ambulance.

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    Default By-Pass the Bus !!!

    I'm part of a 5 man Career Staff at a Volunteer Station.

    Our main job is supposed to be the Ambulance from 6am to Mid-Night {Two on from 6-4 and me on duty from 4-12} - We handle each situation diffrent -

    Fire Gear is carried on the Ambulance by the Career Crews along with S.C.B.A. and assorted Hand-Tools. - We respond the Ambulance to Fire Scenes if we're not needed to complete an Engine or Ladder Crew which is most of the time we're needed.

    We are mainly EMT's but when the Siren Blows we're all firefighters -

    We respond on the apparatus for all reported Structure Fires in district - Out of district we hang back if enough volunteers respond....I say IF !

    If we're on the road and available {IE Returning from the E.R.} and a confirmed working alarm comes in depending on our location we'll either head to the scene or back to the station to man the next rig. - If it's unknown we continue on to the station unless we're closer to the call then we'll investigate {Which ticks off the volunteers when we go on scene 1st. and clear it before they get there like careless cooking and minor stuff - We carry gear, S.C.B.A., Camera, tools so why not ??? }

    To answer the question in todays fire service whether career or vollie we have to assume dual roles and utilizing yur EMS crews as Firefighters is the way to go --- It doesn't work for everyone but for us and the other 20 companies in our county it works.

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    we staff our EMS units with 3 people, 2 of which are Paramedics, ALL three are firefighters. One medic stays outside to provide immediate medical care if needed, and the other 2 will be assigned firefighting duties as needed by the IC,

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    We are an all Volly department. There are a handful of us who are both EMTs as well as FF's. If the EMTs aren't attending to a patient we use them to change the bottles for our FFs. They also get us drinks. As part of getting off probation, all EMTs are required to have "working knowledge" of the rescue truck. It's never happen but they're supposed to be able to go for tools off the rescue truck. In the event a FF/EMT makes it to the scene in the ambulance, and if they're not attending to a patient, they can either be a "gofor" or change bottles as well. If they're qualified to drive/pump, and if the situation calls for it they may pump. In wheich case another ambulance will be requested.
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    For us, Ambulance is a separate organization so utilizing them as part of the fire ground doesn’t work out all that well. Their main goal is to be on stand-by incase anyone needs medical attention, be they "civilian" or firefighter. The ambulance is usually staged in rehab so that firefighters can get a once over while resting and replenishing their fluid levels.

    At our last working structure fire, we happen to get lucky and the ambulance crew that was assigned to us was staffed by firefighters from a neighbouring department (who was actually called for mutual aid for their tender). While they were not engaging in actual fire fighting, they did chip in where they could by helping with staging tenders, laying hose and setting up portable tanks, etc, etc.

    It is fairly standard practice for an ambulance to be dispatched to a fire, either automatically, or by request of the IC. It never hurts to have them around, especially if things go downhill.
    "No one ever called the Fire Department for doing something smart..."

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    ..........
    Last edited by StLRes2cue; 11-16-2005 at 11:30 PM.

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    We have 3 houses, paramedics on every truck 24/7 (90% of the time)

    - 2 ALS Ambulances
    - 2 Rescue Pumpers
    - 1 100ft Platform

    Our city is divided in half for EMS, the ambulance in that district goes on any 1st alarm and performs as necessary when they arrive. They most of the time are the 2nd unit on the scene, so they pack up (each ambulance has 2 airpacks, FF hand tools and a Thermal Camera)and meet up with the Engine from their house and support them or pull a back-up line or vent....whatever their house truck is doing.

    Unless, there is an injury, smoke inhalation...etc. Then they lose the FF packs/tools and bring the stretcher up to the house and do strictly EMS work.

    It seems to work for us, the only downside is once in a while you sit at the firehouse and listen to a fire on the other side of town while you cover the whole area as the last EMS unit available.

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    We have 5 medic rigs in the city with 2 ff/medics on board. Medic rigs are dispatched to all working fires (not car or dumpster).
    The medics typically do the primary search, or pull a line as needed.
    If they get there late, they may "stand by" for a little while, but once the fire is under control they are cleared back in service.
    Actually works out great for us ff/medics- we dont go to false alarms, we dont do overhaul, and we leave when the fire is out.
    Not a bad system
    "Don't just do something, stand there!!!"

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    Our ALS ambulances each have two SCBA, a 6 foot hook, and a set of irons. The EMT and Medic carry their bunker gear, and go in service at working fires, usually with forcible entry and S & R, or however they are needed.
    "Loyalty Above all Else. Except Honor."

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    Hey StLRES2CUE.....


    Long time no see...how've you been?

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    Misread the subject

    Edited out my unrelative answer
    Last edited by Imalazypup; 01-13-2005 at 06:05 PM.

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    We, like 99% of departments, also operate with minimum staffing. We operate 3 per engine and truck. Standard dispatch for a residential is 3 engines, 1 truck, 1 rescue (med unit) and 1 squad (4 personnel), 2 chiefs. That gives us 20 counting chiefs, drivers, etc.

    Until a few years ago, our rescues crews were allowed to be utilized in FF operations. Now, the rescue crew is dedicated to rehab/ medical. I think utilizing the rescue crews for firefighting definately leaves your crews at risk. I for one do not want a FF to go down due to heart attack, injurie, etc and not have a crew ready to treat him.

  18. #18
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    must be nice.....currently a FF/EMT and when we are working on the ambulance we only do bandaid wacker work, extremely painful when we arrive first and the first fire apparatus has 2-3 guys and you are better trained them all of them but are stuck with a standby, happens alot. Weird too, 2nd ambulance is requested on all "jobs" and the first crew doesnt transport, but we have to stand by the cooler of gatorade. my 2 cents

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    Default Question for StLRES2CUE

    Hey StLRES2CUE...could you email me off-post...I have a couple of questions for you about your area...Thanks

  20. #20
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    Hey StLRes2cue...

    check your yahoo email....for some reason my firehousemail.com won't let me send a reply to the addy you used to send me an email...


    fieldseng2

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    Montgomery County Fire Protection (KY) district uses their medic crews to do initial attack if needed.

    They prefer to use then in support operations but when all h--- breaks loose they make the attack with the engine crews.

    They our crossed trained as firefighters and paramedic.The system works well due to staffing limits.

    In most ares of eastern Kentucky ambulance service provider is a third service or private based.In most of those cases EMS standby for EMS operations only.

    If things get a lttle busy most of their crews have some crossed trained personal who could catch an hydrant or help stretch a line.

    This is a grey area however, due to the risk of injury while preforming non-ems duties.
    Always a day late and a dollar short!

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    On my career department we run 2 ALS rescues with a rescue officer and a firefighter both are cross trained. At fires depending on certain factors such as amount of fire, life hazard, etc. the first bus will be utilized as an interior company. The second is usually EMS/Rehab. Unless the situation warrants it. We have a minimum of 21 per shift including the 4 on the busses. In my volly department we have paid rescue crews of an EMT-B and an ALS provider either Paramedic or EMT- Cardiac. 2 busses from 6a to 6p. If fire call comes in they respond and operate as fire crew due to staffing concerns.
    "I have no ambition in this world but one, and that is to be a fireman. The position may, in the eyes of some, appear to be a lowly one; but we know the work which a fireman has to do believe that his is a noble calling."

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    We use our medics as our RIC. we have 5 stations with 2 man engines and two or three ambulances with cross trained medics/firefighters. The ambulances have all their personal gear plus BAs, Forcible entry tools etc. If the medic is out the second one takes its place.

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    Red face

    I won't take too much time, but just a little info on how we do it here..
    Our dept. is the county, but we also work side by side with the city and surrounding area dept.'s in the EMS field(and fire). The way it works out here is simple--We have a North Medic, a South Medic and the county medic who has a seperate call sign designation. Each dept. in the county and the city, just sent a member of their crews to medic school(one from blue, one from red and one from green). That means that six new medics just came into play, and they are all cross trained in fire. Now both dept.'s have students in this years medic program, which means by this time next year, between the county and the city, there will be 15 medics available + one who is the county's assistant EMS co-ordinator. The medics usually respond in a chase cars, thus freeing up all others to fight the fires. EMT's who are EMS only are expected to run re-hab only, they also assist the PR man with making sure families get blankets, water, or brought out of inclement weather and made as comfortable as possible. (or atleast that's what I do when I'm on the bus) Since I am trying to cross train in fire as well, I also help pull hose, hook up to hydrants and get tarps out for salvage and clean-up operations( as do most of the new recruits). If our ambulance is tied up at a fire scene, the city covers are calls, and vice-versa
    Okay, so I took longer than I thought, what can I say, I get excited about our system We work so well!
    Good luck with finding the way that works best for you!

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